Diabetes affects the lives of hundreds of millions of people worldwide and the incidence rate is continuing to rise. About 8% of the US population is estimated to have Type 1 or Type 2 diabetes, with the prevalence of Type 2 diabetes increasing with the rise in obesity. Even though the etiology of Type 1 and Type 2 diabetes is different, the end stages show a similar reduction or loss of pancreatic insulin secretion. This is caused by destruction of the pancreatic beta cells which produce and secrete insulin in response to serum glucose levels. Current diabetes therapies do not offer the degree of metabolic control needed to prevent the progression of the disease to the serious complications and mortality that occur when glucose control is lost. The potential for excellent, long-term glycemic control offered by a "beta-like", insulin producing cell is the rationale for our proposal. This cell would release insulin in a physiologically controlled, glucose-dependent manner, responding minute-to-minute to acute changes in blood glucose levels. In this situation, diabetes would be completely controlled. We have obtained significant preliminary data suggesting that adipose-derived stem cells can be differentiated in culture to "beta-like" insulin producing cells, and propose to develop applications of these cells for use in cell therapy and drug development. It is our goal to identify and characterize an optimized adult stem cell population from human adipose tissue that has the therapeutic potential for the treatment of diabetes. PUBLIC HEALTH RELEVANCE: Current diabetes therapies do not offer the degree of metabolic control needed to prevent the progression of the disease to the serious complications and mortality that occur when glucose control is lost. Our objective is to identify and characterize an adult stem cell population from human adipose tissue that has the therapeutic potential to differentiate into insulin-secreting pancreatic "beta-like" cells. If successful, this work would offer the possibility for cell treatment and possible cure of type 1 and type 2 diabetes.